Posted 9/6/2013 10:09 PM (GMT 0)
Beanbagger,
I'm sorry to hear that treatments haven't worked both times. The nightmare never ends!
I trust that you've had the requisite bone scan and there are no obvious bone mets. I can't tell whether you've already had some hormone therapy along with your SRT. Many ROs prescribe that starting a few months before SRT and running for many months afterwards to help your immune system clean up any strays. There's a lot of controversy over whether 6 months, 18 months, or 2 years or longer is best, but some seems better than none.
After that, there's one more trick available before you have to resign yourself to lifelong hormone therapy. In a certain percentage of men who have failed RP and SRT, the cancer comes to reside for a while in some of the regional lymph nodes, and if there are few enough such sites (5 or less, called "oligometastatic cancer") there's a chance that you can zap them away with five short SBRT (radiation) treatments.
The hard part is finding them. There are only a few imaging techniques capable of finding such small lymph node mets. Unfortunately, none are widely available, and I doubt that insurance will cover any of them. One is a kind of MRI that uses nanoparticles of iron oxide that don't get uptaken well in cancerous lymph nodes. The others are kinds of PET scans - C11 Acetate, C11 Choline, and the more recent but very promising FACBC PET.
I hope you have a good urologic oncologist with whom you can discusss all these options.
- Allen